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About ADD-The Basics You Need to Know
Attention Deficit Disorder (ADD) is the term used for a neurological condition
marked by difficulties with attention and concentration and usually difficulties
with self-control and overactivity or restlessness. It is also known as Attention
Deficit Hyperactivity Disorder (ADHD) because many individuals with ADD are or were
overactive and impulsive. About 5% of all people have ADD.
ADD is recognized by mental health professionals as one of the most common disorders
of childhood, and was previously thought to resolve in adolescence. Over the past
decade there has been a growing awareness that for many if not most individuals with
ADD it persists into adulthood. Effective treatment for adult ADD is a relatively
new area of study.
ADD affects many aspects of life. It affects academic and vocational success, personal
and family relationships, emotions and self-esteem. ADD individuals often share a
number of positive qualities such as creativity, spontaneity, inventiveness, and
sensitivity to others. But it also leads to disorganization, procrastination, difficulty
with task completion, and feeling overwhelmed.
The Nature of ADD
ADD is commonly described as a disorder consisting of chronic difficulties in the
areas of attention/concentration, impulsivity, and overactivity. In addition to these
"core" symptoms, other symptoms and problems include distractibility, forgetfulness,
lack of persistence with tasks, frequent boredom, failure to delay speech or action
when appropriate, fidgetiness, restlessness, being "always on the go,"
disorganization, difficulty coping with stressful situations, temper outbursts, and
frequently changing moods. Not every ADD individual displays all these symptoms.
Some ADD individuals have mainly the attentional difficulties and do not have the
overactivity and impulsivity. These symptoms frequently lead to low self-esteem,
problems with planning and executing tasks, a disorganized lifestyle, poor problem-solving
skills, frequent job or relationship changes, social and relationship difficulties,
a chronic pattern of underachievement, and/or inconsistency in work production and
performance. Children often display problems with behavior, socialization, and school
performance. Many individuals with ADD may have a coexisting problem such as anxiety
or depression, a learning disability, or drug/alcohol abuse. It may be that they
focus on and seek help for this problem, not recognizing its link to ADD.
Causes
ADD is widely recognized among experts as having a biological, neurological basis.
It is currently understood as the result of a part or parts of the brain not regulating
self-control of attention, impulses, and activity level as it should, likely due
in part to a lack of certain neurochemicals. While it is usually an inherited condition,
it may be exacerbated by environmental and other factors such as parenting, adversity,
or educational environment.
Progression
ADD individuals are generally born with ADD. It usually becomes manifest in early
childhood. Often it becomes more apparent during elementary school years because
of the demands of school experience. For some individuals it may not become apparent
until later in life. During adolescence changes in the ADD manifestation often occur.
It may be less outwardly obvious, especially when hyperactivity diminishes. For some
individuals, it seems to end. For the majority, it usually continues to impact in
many ways throughout adulthood, although greater control may be achieved in various
ways.
Diagnosis
ADD is widespread in our society. It seems males are much more likely to be diagnosed
with ADD than females. There is no definitive test for ADD, and it is one of the
most difficult diagnoses to assess. ADD can only be diagnosed by a mental health
or medical clinician trained and experienced in the area of ADD. Comprehensive interviews
covering childhood and adult history of academics, relationships, behavior, etc.
are necessary to establish a diagnosis. Rating scales and certain tests are often
helpful and employed. Because the main symptoms of ADD overlap with other conditions
as well as with "normal" experience, a qualified professional is required
to rule out other conditions that may produce symptoms resembling ADD. ADD should
not be self-diagnosed. If you think you have ADD it is recommended that you consult
a professional.
Treatment
ADD is not an all or nothing condition, but occurs in degrees. It is possible to
have a mild case that can be relatively easy to manage. Some people have severe symptoms
and problems that can impair their functioning greatly. Even severe ADD can, with
effort, medication, and support, be managed effectively.
People with moderate to severe problems related to ADD should consider treatment
with a professional with training and experience in ADD. Medications can be helpful.
Counseling is often indicated to deal not only with the symptoms, but also the resulting
issues related to emotions, self-esteem, relationships, work performance, school
performance, etc. Parent counseling has been shown to be effective in helping children
with ADD. Coaching is another service providing support for ADD. Greater effectiveness
and reaching of potential can be had. There is much that can be done to help the
individual struggling with ADD.
Learning new ways to gain control of ADD-related problems is an important part of
coping with ADD. A first step is to gain insight and understanding of how ADD impacts
in your life. This understanding can then be used to identify the challenges and
eventually to develop new strategies and skills for dealing with your (or your child's)
ADD symptoms and problems. A counselor or therapist specializing in the treatment
of ADD can be very helpful in this process.
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Increase structure. |
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Examples: organize, establish routines, and develop specific goals and step-by-step
plans. Utilize lists, schedules, and simple systems. Prioritize tasks and things
to do. Break down large projects into parts and develop a step-by-step plan. |
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Exercise. |
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Exercise reduces restlessness, clears the mind, improves concentration, has a calming
effect, and improves mood. Take a brisk walk for 5-10 minutes periodically during
the day. Exercise for longer periods (30 minutes or so) every day or every other
day |
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Take frequent breaks. |
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Work within your attention span. Concentrate on a task for 20-30 minutes and allow
a short break to refresh and replenish. Walk around during your break. |
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Variety, novelty. |
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Variety and novelty help rejuvenate and sustain interest, motivation, and persistence.
Try to develop more variety and novelty in your life and work. |
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Planned task-shifting. |
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Ordinarily, shifting tasks before completion of a task is a problem for individuals
with ADD because tasks don't get done. However, within a reasonable framework, you
can make this natural tendency work for you. Set yourself up with 2-3 tasks and alternate
between them after intervals of about a half-hour. Changing tasks can rejuvenate
your concentration, etc. Example: alternate between paperwork (1/2 hour) and errands
(1/2 hour). Or when you have a lot of reading, alternate between two books. |
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Modify your work environment. |
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Do what you can to minimize distractions. Find a quieter place to work. Try changing
locations periodically. Reduce clutter. |
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Do concentration-intensive work at peak hours. |
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Determine what time of day (i.e. morning, afternoon, evening, etc.) your ability
to concentrate is strongest. Plan to do work that requires concentration during this
time of day, and schedule work that requires less concentration during periods of
the day when your ability to concentrate is not as good. |
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Anti-impulsivity self-statements. |
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Develop catchy phrases to say to yourself to help you refrain from impulsive action.
Repeat them to yourself vigorously in key situations. Examples: "be careful",
"don't rush this", "take your time", "slow down", "don't
make a hasty decision", "take a step back, think, and then decide",
"think before you act." |
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Don't rush into decisions. |
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Put important decisions "on the back burner" for a while, for further reflection.
Example: instead of buying something expensive on impulse, get yourself to delay
for awhile and walk around the mall some more. You can come back and buy it if it
still seems like a good idea. |
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"Stop, think, make a plan." |
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In key situations, catch yourself, slow down, think ("what will happen if I
. . .") before acting. Inhibit "knee-jerk" reactions. Train yourself
to think before you act, using these three steps: 1. Stop - catch yourself; 2. Think
about possible actions and about potential consequences; 3. Make a plan to deal with
the situation. |
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Provide a structured environment. |
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ADD children function better in a structured, scheduled, predictable environment.
Is your home somewhat hectic and chaotic? If so, the unpredictability and lack of
structure and routines may be adding to the difficulties of your ADD child. To increase
structure, develop daily schedules and routines, predictable rules and consequences,
more supervision, more organization, etc. |
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Create incentive. |
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Incentive makes a big difference in behavior. Incentive exists when the task at hand
is more interesting or fun, or there is a predictable and meaningful reward or consequence.
ADD children need to know it's worth their effort to behave appropriately. |
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Action, not words. |
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ADHD children misbehave most often not because they don't know what is right, but
because they have a performance problem. Lectures, nagging, and tirades are not helpful.
Children learn best from the consequences of their behavior. Use immediate consequences
- rewards for good behavior, penalties for misbehavior. Don't delay. |
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Set up for success. |
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Before tackling a problem, it sometimes helps if we can take a step back and look
at what may be contributing to the problem. We can then work on changing those things
first. Here are some ideas to consider: rearrange the environment/develop consistent
routines/make sure your commands and requests are clear, polite, and understood/treat
each other with care, respect, and love/teach new skills/clarify rules and expectations/be
consistent with limit-setting and discipline. |
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Positives before negatives. |
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A good relationship with your child, one that emphasizes the positives of the child
and your appreciation of good behaviors, is important if discipline methods are to
be effective and self-esteem is to be maintained. Catch your child doing something
right. Be fast and liberal with praise. Make sure your child receives large doses
of positive attention on a consistent basis. Provide meaningful rewards for good
behavior. Focus on strengths. Increase positive interactions. |
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Be careful what behaviors you allow to succeed. |
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Be careful not to reinforce misbehavior by giving too much attention, giving the
desired payoff, backing down or arguing in a power struggle, etc. Parents often inadvertently
reinforce misbehavior (whining, temper tantrums, defiance, sulking, etc.). Identify
the payoff maintaining a repetitive misbehavior, and withhold it. |
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Become skilled in delivering appropriate consequences for
your child's behavior. |
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Pay attention to your child's behavior-good and bad-and follow-up with appropriate
consequences. Children learn behavior and are motivated by the outcomes and results
of their behavior. For good behavior, make sure it is recognized and rewarded immediately-specific
praise, tangible rewards, positive attention, special privileges. For bad behavior
- ignore unimportant misbehavior, set limits on more significant misbehavior and
follow through consistently with negative consequences. Determine in advance what
consequences are appropriate and make the punishment fit the crime. Make sure the
rules are clear beforehand. |
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"Stop, think, make a plan." |
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Promote good problem-solving skills and help your child reduce impulsive behavior
by coaching your child to catch himself, slow down, and think "what will happen
if...," in key situations. Teach and prompt your child to think before acting
using three steps: 1) "STOP" - catch yourself; 2) "THINK" - about
possible actions and potential consequences; 3) "MAKE A PLAN" - to best
deal with the situation. Parents can help their children learn to problem solve by
prompting and reinforcing the use of this strategy. |
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Anticipate problems and have a plan. |
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ADHD children often repeat the same problems in similar situations over and over
again. You can anticipate what settings may be difficult. Prepare and have a plan
for these situations. As you enter an anticipated situation, follow these steps:
1) review the rules; 2) set up a reward for appropriate behavior (incentives), 3)
set up a penalty for disobeying the rules; 4) give positive attention for good behavior;
5) follow through with consequences. |
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Change unhelpful thinking. |
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Many children with ADHD become negative thinkers over time due to the accumulated
negative experiences they have. Self-esteem can suffer. Help your child to identify
their own negative thoughts, and counter the unhelpful thinking with helpful thinking.
Ask: "Why did you think that?" and "How do you feel when you think
that?" Then help your child to think of more helpful thoughts to replace the
unhelpful ones. Try to model realistic, positive thinking. Learning how to cope with
mistakes and failures is important for ADHD children. Emphasize that making a mistake
does not mean that he is stupid or bad. |
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| Click here to request the free Life Skills newsletter, sharing helpful ideas
about dealing with life's challenges. (Your personal information will be kept confidential.) |
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William D. Morgan, Psy.D.
Dr. Bill Morgan is a psychologist specializing in counseling, assessment, and
professional coaching. He offers an encouraging approach to growth and increased
effectiveness for adults and students with ADD and parents of children with ADD.
His services include:
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Assessment and testing for ADD/ADHD and learning differences |
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Counseling for ADD/ADHD related issues |
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Personal, career, and executive coaching for adults with ADD |
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Parent counseling, training, and coaching for ADD/ADHD children |
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Coaching ADD college students for academic success |
Dr. Morgan's approach is distinctively growth-oriented, emphasizing gaining the skills
needed to handle life's challenges
Dr. Morgan is a licensed psychologist. He is a member of the American Psychological
Association, the International Coach Federation, and Children and Adults with Attention
Deficit/Hyperactivity Disorder (CHADD). Dr. Morgan is on the professional advisory
board of Chester County CHADD and holds an adjunct faculty position at Widener University.
He has published several professional articles on ADD/ADHD and is a popular speaker
on the subject.
Dr. Morgan's offices are located in the greater Philadelphia, PA area at:
William D. Morgan, Psy.D.
63 Chestnut Road
Paoli, PA 19301
Voice: (610) 644-8182
Email: info@manageadd.com
For those outside the Philadelphia, PA area, Dr. Morgan offers telephone consultations
and coaching services. Contact Dr. Morgan for more information about his services,
set up a consultation, or inquire about becomming a client.
For more information about Dr. Morgan's assessment and counseling services click
here.
For more information about Dr. Morgan's telephone consultation and coaching services
click here.
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| Click any book cover for more information about the respective title. |
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Out of the Fog: Treatment Options and
Coping Strategies for Adult Attention Deficit Disorders
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You Mean I'm Not Lazy, Stupid, or Crazy?!
A Self-Help Book for Adults with Attention Deficit Disorder
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Kevin Murphy and Suzanne Levert
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Kate Kelley and Peggy Ramundo
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Taking Charge of ADHD
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ADD in the Workplace
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Russell Barkley
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Kathleen Nadeau
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Is Your Child Hyperactive? Inattentive?
Impulsive? Distractible?
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Putting On the Brakes Young Peoples Guide
to Understanding Attention Deficit Hyperactivity Disorder
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Stephen Garber et al
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Patricia Quinn and Judith Stern
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Your Defiant Child : Eight Steps to Better
Behavior
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Attention Deficit Disorder and Learning
Disabilities
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Russell Barkley and Christine Benton
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Barbara Ingersoll and Sam Goldstein
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Driven to Distraction
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What Does Everybody Else Know That I Don't?
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Edward Hallowell and John Ratey
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Michele Novotni and Randy Peterson
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ADD and the College Student
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The Explosive Child
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Patricia Quinn
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Ross Greene
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Adult ADD
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A.D.D. On the Job- Making Your A.D.D.
Work for You
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Thomas A. Whiteman, Ph.D.and Michele Novotini, Ph.D.with Randy
Petersen
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Lynn Weiss
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Professional coaching for ADD is a one-on-one collaborative relationship where a
client is assisted in achieving important goals to improve his or her life, relationships,
work performance, or career success. Coaching is a place where clients look at their
life, how they are doing, and how to best reach their full potential by getting better
control of ADD. Coaching services are offered in-person or by telephone. Telephone
coaching appointments make coaching convenient, focused, and available all over the
country, even overseas.
The ADD coach helps individuals learn new strategies to overcome areas of difficulty
and more quickly and easily reach important goals. The coach offers suggestions,
and provides structure and support. Organization, time management, task completion,
and productivity are often a client's concern. Decreasing stress and overwhelm, and
enhancing relationships are also common areas addressed. Through coaching, clients
learn and apply strategies that can lead to greater work, academic, and relationship
success. An ADD coach understands the challenges of ADD and knows ways of getting
better control of ADD. The ADD coach helps clients to identify areas of needed improvement,
assesses strengths and weaknesses, and with the client develops new coping strategies
for areas of needed development. Structure, support, skills, and strategies are key
ingredients in ADD coaching.
Coaching is also available to parents of ADD children to help them develop successful
parenting approaches for their ADD child. The ADD coach understands the challenges
of parenting an ADD child, and can provide insight, advice, guidance, resources and
support for successfully dealing with parenting challenges.
Click here to request additional information about Dr. Morgan's
ADD coaching services. |
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Dr. Morgan may be contacted at:
William D. Morgan, Psy.D.
63 Chestnut Road
Paoli, PA 19301
Voice: (610) 644-8182
Email: info@manageadd.com |
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